The effect of Da Vinci robot vs laparoscopic anterior resection for rectal cancer on anorectal and urogenital function / 中华普通外科杂志

Objective:To compare the postoperative anorectal and urogenital function in patients undergoing Da Vinci robot vs laparoscopic total mesorectal excision (TME) for middle and low rectal cancer.Methods:A prospective controlled study was conducted to analyze the clinical data of 120 patients with middle and low rectal cancer receiving low anterior resection (Dixon procedure) at the Department of Gastrointestinal Surgery, Guizhou Provincial People's Hospital from Jun 2020 to Oct 2022, including 65 patients in the laparoscopic surgery group and 55 patients in the robotic surgery group.All patients underwent colonoscopy and pelvic MRI, and the distance of the tumor from the anal margin was less than 10 cm.The clinical data of the patients were collected and followed up by questionnaire at 12 months after operation. The anal defecation function was assessed by Wexner constipation score and low anterior resection syndrome scale (LARS).The urinary function was measured by International Prostate Symptom Score (IPSS) and International Advisory Committee on Urinary Incontinence Lower Urinary Tract Symptom Scale (ICIQ-MLUTS/ ICIQ-FluTS).Reproductive function was valued by International Index of Erectile Function (IIEF-5 score) was used for male function and the sexual function index (FIFS-19) for females.Results:The postoperative anal defecation function in robotic group was better than that of the laparoscopic group, and the LARS score was (4.3±2.2) vs. (9.8±1.5), t=9.151, P=0.038.There was no serious urinary dysfunction in neither groups. The robot group had a certain advantage in the protection of male urinary function [ICIQ-MLUTS, (1.8±5.8) vs. (13.8±4.9), t=4.128, P=0.038], while there was no significant difference in the female urinary function between the two groups .ICIQ-FLUTS [(-0.3±1.0) vs. (-0.2±0.9), t=0.015, P=0.844].There was no significant difference in reproductive function between the two groups, IIEF-5 score [(-13.4±2.7) vs. (-11.7±3.4), t=0.35, P=0.615]. FIFS-19 [(-5.2±4.6) vs. (-10.5±6.4), t=4.128, P=0.254]. Conclusions:Compared with laparoscopic surgery, robotic surgery has a better possibility of anal defecation after middle-low rectal cancer surgery. The robotic group has certain advantages in male urinary function protection, and the two surgical methods have similar effects on reproductive function protection.

Establishment of TMJ defect models and evaluation on repair effect of CFR-PEEK material artificial joint in rabbits / 吉林大学学报(医学版)

Objective:To investigate the method of arthroplasty for reconstructing femporomandibular joint (TMJ) after the establishment of TMJ articular defect models in the rabbits,and to clarify the replacement and repair effects of carboh fiber reinforced polyetheretherketone (CFR-PEEK) material TMJ prostheses,and to provide an experimental basis for the clinical application of CFR-PEEK artificial joints to replace TMJ.Methods:Thirteen healthy adult Japanese rabbits were randomly divided into experimental group (n=6),positive control group (n=4) and negative control group (n =3).The right TMJ articular process of the rabbits in experimental group were resected to establish the joint defect models,and then the CFR-PEEK artificial joints were impanted.The right TMJ articular process of the rabbits in positive control group were resected,and the joint defect models were established without the CFR-PEEK artificial joint implantation.The rabbits in negative control group didn't receive any treatment.The body weights of the rabbits in each group were measured in 13 weeks.The effects of fixation and replacement after artificial joint implantation were assessed by CT imaging.Results:The TMJ articular process defect model was successfully implanted with the CFR-PEEK artificial joint.The CT imaging results after threedimensional reconstruction and CT images by contrast in vitro showed that the CFR-PEEK-implanted artificial joint was fixed well,it could be instead of the normal joint function.Compared with positive control group,the weights of rabbits in experimental group were significantly increased (P＜ 0.05) at 13 weeks;compared with positive control group,the weights of rabbits in experimental group and negative control group were both significantly increased (P＞0.05) at 13 weeks,but there was no significant difference between them (P＞0.05).The weights of rabbits in experimental group and negative control group kept normal growth;the weights of rabbits in positive control group was increased slowly,and even stopped growing or was negative.Conclusion:The CFR-PEEK artificial joint can be successfully implanted into the TMJ defect model and be used to repair the defect which help to restore chewing function.The CFR-PEEK is expected to be an ideal material for reconstructing TMJ.

Establishment of TMJ defect models and evaluation on repair effect of CFR-PEEK material artificial joint in rabbits / 吉林大学学报(医学版)

Objective:To investigate the method of arthroplasty for reconstructing femporomandibular joint (TMJ) after the establishment of TMJ articular defect models in the rabbits,and to clarify the replacement and repair effects of carboh fiber reinforced polyetheretherketone (CFR-PEEK) material TMJ prostheses,and to provide an experimental basis for the clinical application of CFR-PEEK artificial joints to replace TMJ.Methods:Thirteen healthy adult Japanese rabbits were randomly divided into experimental group (n=6),positive control group (n=4) and negative control group (n =3).The right TMJ articular process of the rabbits in experimental group were resected to establish the joint defect models,and then the CFR-PEEK artificial joints were impanted.The right TMJ articular process of the rabbits in positive control group were resected,and the joint defect models were established without the CFR-PEEK artificial joint implantation.The rabbits in negative control group didn't receive any treatment.The body weights of the rabbits in each group were measured in 13 weeks.The effects of fixation and replacement after artificial joint implantation were assessed by CT imaging.Results:The TMJ articular process defect model was successfully implanted with the CFR-PEEK artificial joint.The CT imaging results after threedimensional reconstruction and CT images by contrast in vitro showed that the CFR-PEEK-implanted artificial joint was fixed well,it could be instead of the normal joint function.Compared with positive control group,the weights of rabbits in experimental group were significantly increased (P＜ 0.05) at 13 weeks;compared with positive control group,the weights of rabbits in experimental group and negative control group were both significantly increased (P＞0.05) at 13 weeks,but there was no significant difference between them (P＞0.05).The weights of rabbits in experimental group and negative control group kept normal growth;the weights of rabbits in positive control group was increased slowly,and even stopped growing or was negative.Conclusion:The CFR-PEEK artificial joint can be successfully implanted into the TMJ defect model and be used to repair the defect which help to restore chewing function.The CFR-PEEK is expected to be an ideal material for reconstructing TMJ.

Orientaciones socialmente responsables para la permanencia estudiantil en programas de educación a distancia de la Universidad Industrial de Santander - UIS

Ante las dinámicas sociales del mundo actual, la educación a distancia se ha convertido en la principal estrategia orientada al aumento de capacidades y oportunidades para alcanzar niveles óptimos de bienestar social. No obstante, a pesar de programas flexibles que facilitan la vinculación universitaria como Tecnología y Gestión Empresarial, ofertados por el Instituto de Proyección Regional y Educación a Distan-cia-IPRED de la Universidad Industrial de Santander - UIS, el número de graduados en comparación con los ingresantes no es el esperado: durante el periodo 2007-2009 se identificó un índice de abandono del 55 % y 28% respectivamente. Este estudio cuantitativo de diseño descriptivo a partir de la muestra aleatoria estratificada permite la identificación de características, patrones de conducta y actitudes, para señalar los comportamientos concretos de los desertores. Como resultado, se estableció que las motivaciones socioeconómicas de abandono escolar están interconectadas con otras variables, afirmando un fenómeno multicausal que orienta a la construcción de estrategias socialmente responsables de seguimiento y permanencia, en procura de su disminución, en el marco de la Responsabilidad Social de la UIS.

In light of the social dynamics in today's world, Distance Education has become the main strategy aimed to increase capacities and opportunities, in order to achieve optimal levels of social welfare. However despite of the flexible programs that facilitate university linkage such as Technology and Business Management, offered by Instituto de Proyección Regional y Educación a Distancia - IPRED of Universidad Industrial de Santander-UIS, the number of graduates compared to the number of newcomers is not the expected: during the period of 2007-2009 it was identified a dropout index of 55% and 28% respectively. This quantitative study of descriptive design it's based in a stratified random sample, and allows the identification of characteristics, behavior patterns and attitudes, in order to indicate the specific behavior of the deserters. As a result, it was established that socioeconomic motivations of dropout are interconnected with other variables, affirming a multi-causal phenomenon that guides the construction of socially responsible strategies of monitoring and permanence, in the pursuit of its decrease, in the framework of Social Responsibility of UIS.

Dada a dinâmica social do mundo de hoje, a educação a distância se tornou a principal estratégia destinada a aumentar as capacidades e oportunidades para atingir níveis ideais de bem-estar social. No entanto, apesar dos programas flexíveis que facilitam a ligação universidade como Tecnologia e Gestão de Negócios, oferecido pelo Instituto de alcance regional e Educação a Distância-IPRED da Universidade Industrial de Santander - UIS, o número de graduados em comparação com ingresantes não se espera: durante o período de 2007-2009 uma queda do índice de 55% e 28%, respectivamente, foi identificado. Este projeto estudo descritivo quantitativo a partir de amostra aleatória estratificada permite a identificação de características, padrões de comportamento e atitudes, para indicar o comportamento específico dos desertores. Como resultado, foi estabelecido que as motivações socioeconómicas das desistências estão interligadas com outras variáveis, alegando um fenômeno multicausal que visa a construção de estratégias de monitoramento e permanência socialmente responsável, em busca de seu declínio, no âmbito da Responsabilidade Social a UIS.

Treatment of acute tibial osteomyelitis and massive sort tissue defection using Ilizarov bone transport and dressing change / 中国综合临床

Objective To investigate the clinical efficacy of Ilizarov bone transport combined with dressing change in the treatment of acute tibial osteomyditis accompanied with massive soft tissue defection.Methods From July 2009 to september 2012, 14 patients with acute tibial osteomyelitis associsted with large-area soft tissue necrosis and defection were treated in Traumatic Orthopaedics Department of the Central Hospital of Binzhou.All cases were Gustillu Ⅲ type open fracture, and Ⅲ C type injury in 11 casas accompanied with vascular injure.Associated with contralateral lower limb in 4 casas.They were 10 male and 4 female,aged from 21 to 45 years old(average age of 35 years old).The duration from injury to surgery ranged from 12-24 days,averaging of 19 days.All cases were treated first with excision of the infected or necrosis bone segment and soft tissue.The wound keep opening, followed by llizarov bone transport combined with dressing change to repair the bone and soft tissue defection.The clinical efficacy was assessed using the Paley's evaluation system at the last follow-up.Results All the patients were followed up for 24 to 36 months (average of 27 months).The bone defection rapaired was from 5 to 1 3 cm(average of 7 cm).The mean duration of distraction was 4 months, range from 2 to 6 months.All cases' gain s.ufficient soft tissue coverage the later period of Ilizarov bone transport.All the fracture and bone defection were cured.Infection were cured in 13 cases, and 1 case converted to chronicle osteomyelitis, and the cure rate was 93％.According to the Paley' s system, the bone union was excellent in 11 cases, good in 2 cases, and fair in 1 Cases, with a good-to-excellent rate was 93％.The functional outcome was excellent in 10 cases,good in 2 cases,and fair in 2 cases,with a good-to-excellent rate of 86％.Conclusion Ilizarov bone transport and dressing change is one reliable and effective treatment of tibial acute infected and soft tissue defection.

Cuspal deflection of directly or indirectly restored teeth / Deflexão cuspídea de dentes restaurados direta ou indiretamente

Objective: The aim of this study was to evaluate the cuspal deflection of teeth restored directly and indirectly. Material and Methods: Forty sound maxillary premolar teeth were restored with composite and different base materials. Wide mesial-occlusal-distal cavity preparations were performed, with isthmus width of one third of the distance between the cuspal tips, 3 mm occlusal and a 5 mm interproximal preparation height. The teeth were divided into 4 groups (n = 10), according to the restoration type: G1) GIC-DCR (1 mm glass ionomer cement base and direct restoration using nanoparticulate composite); G2) FL-DCR (1 mm base of flowable composite resin and direct restoration using nanoparticulate composite); G3) GIC-ICR (1 mm glass ionomer cement base and indirect restoration using nanoparticulate composite GIC base); G4) FL-ICR (1 mm base of flowable composite resin and indirect restoration using nanoparticulate composite). The specimens were submitted to compressive load of 50 N on the buccal and lingual cusps, in a universal testing machine. The lingual cusp microstrain (με) measurements were executed by strain gauges. Results: The Kruskal-Wallis (5%) test was used and showed there were no significant differences among the microstrain values for the four study groups (G1 = 1250; G2 = 1075; G3 = 1279; G4 = 937). Conclusion: It could be concluded that the restorative techniques and the bases employed did not show any influences in cuspal deflection

Objetivo: O objetivo deste trabalho foi avaliar, por meio de medidores de tensão, a deflexão cuspídea sofrida por dentes restaurados, direta e indiretamente, com resinas compostas e diferentes materiais de base. Material e Métodos: Para o preparo dos corpos-de-prova (CP) foram utilizados 28 dentes pré-molares humanos íntegros, extraídos por razões ortodônticas que tiveram suas raízes embutidas em poliuretano de densidade semelhante a do osso e suas raízes recobertas por um espaçador visando simular o espaço referente ao ligamento periodontal. Na etapa seguinte os dentes receberam preparos cavitários do tipo mésio-ocluso-distais amplos e então restaurados direta e indiretamente com resina composta e dois diferentes materiais de base/forramento, resina flow e cimento de ionômero de vidro. Para a realização das medidas de deflexão das cúspides foram utilizados extensômetros lineares elétricos colados à face lingual de cada dente e submetidos a uma carga de 50 N aplicada por uma ponta romba de diâmetro de 3,0 mm, que promoveu compressão simultânea nas vertentes triturantes das cúspides vestibular e lingual, numa máquina universal de ensaios. Resultados: Foi realizado o teste de Kruskall-Wallis (5%) de significância e não foram encontradas diferenças estatísticamente significantes entre os grupos (G1 – 1250; G2 = 1075; G3 = 1279; G4 = 937). Conclusão: Pode-se concluir que o tipo de restauração bem como o tipo de base empregados nesse estudo não alteram a deflexão cuspídea dos dentes com restaurações amplas.

Comparison of Osteogenic Potential in vivo between Autologous Bone Marrow Mesenchymal Stem Cell Implanting and Fibrin Sealant Combined with Recombined Human Bone Morphogenetic Protein-2 Grafting / 中国康复理论与实践

@#Objective To investigate the osteogenic potential for size-critical bone defect of fibrin sealant combined with recombined human bone morphogenetic protein-2 (rhBMP-2) grafting and varied autologous bone marrow mesenchymal stem cells (BMSCs) implanting in vivo. Methods BMSCs were cultured and induced with osteogenic supplement (OS) medium. BMSCs with and without OS induction were collected and percutaneously autologous injected respectively into the 15 mm bone defect of experimental rabbit model. The grafts were BMSCs, osteo-induced BMSCs, BMSCs and osteo-induced BMSCs, BMP combined with fibrin sealant, 0.9% NaCl solution. Osteogenesis at the defect area was assessed with regular radiography, histology and biomechanics. Results The FS/BMP group and the BMSCs+osteo-induced BMSCs group achieved complete bone healing with medullary cavity united, with the most new bone formation and the maximal load among those groups. Conclusion The osteogenic potential of both osteo-induced BMSCs combined with BMSCs and FS/BMP are similar, which are superior to that of BMSCs or osteo-induced BMSCs along.

Study of Marrow Stem Cell Transplant for Treatment of Bone Nonunion and Bone Defection / 中国康复理论与实践

@#ObjectiveTo observe the curative effect of marrow stem cell transplant on bone nonunion and bone defection.Methods140 patients were randomly divided into the group A (with auto-iliac bone transplant) and group B (with auto-marrow stem cell transplant). There were 70 cases in each group. All patients in two groups were treated by operation and inside and outside fixation.ResultsAfter treatment, the average cicatrization time of group A was (7.0±2.0) months, that of group B was (5.0±1.5) months, there was a significant difference between two groups( P<0.05). There were no obvious adverse reactions found during the treatment period.ConclusionCompared with the traditional bone grafting, treating bone nonunion and bone defection by auto-marrow stem cell transplant has obvious superiority with better curative effect, short course and no adverse reactions.

Ocorrência de diferentes tipos de canais acessórios cavo inter-radiculares em molares de humanos. Estudo histológico / Ocurrence of different types of cavo inter-radicular accessory canals in human molars. A histologic study

Apesar de haver muitos estudos que mostrem a prevalência e o diâmetro dos canais acessórios na região de furca, há escassez de trabalhos que observem o trajeto e os diferentes tipos de canais cavo inter-radiculares. Assim, o objetivo de nosso estudo foi verificar a ocorrência dos diferentes tipos morfológicos de canais acessórios na região de furca, na tentativa de mostrar os seus trajetos, através de cortes histológicos em molares de humanos. Foram utilizados 40 terceiros molares inferiores inclusos com separação radicular, os quais foram extraídos e descalcificados para a realização de microtomia no plano axial mésio-distal, obtendo-se cortes semi-seriados com espessura de 5µm. Os cortes foram corados com Hematoxilina e Eosina e observados em microscopia ótica em 40X, 100X, 200X e 400X. Os resultados mostraram que todos os tipos morfológicos foram encontrados, sendo que os canais acessórios verdadeiros, do tipo A estavam presentes em 10% dos espécimes. Os canais mais prevalentes foram os microcanais do tipo E, com prevalência de 100%, seguidos pelos fechados do tipo D com 87,5%, e pelos cegos do tipo B, com 75%. Os canais acessórios em alça, do tipo C, foram observados em apenas 5% dos dentes, sendo os menos prevalentes

Although there are several studies that show prevalence and diameter of accessory root canals in the furcation area, there is a scarceness of studies which observe the trajectory and different types of cavo inter-radicular canals. The objective of the present study was to verify the occurrence of different morphologic types of accessory root canals in the furcation area, in an attempt to show their trajectories, through histological sections in human molar teeth. Forty unerupted mandibular third molar teeth with radicular separation were used. They were extracted and decalcified so that microtomy could be performed towards mesio-distal axial plane, obtaining semi-serial sections with thickness of 5µm. The sections were stained with Hematoxylin and Eosin, and were observed under optical microscopy at 40X, 100X, 200X and 400X magnifications. The results showed that all morphologic types were found; the real accessory canals, type A, were present in 10% of the specimens. The most prevalent canals were type-E microcanals, with prevalence of 100%, followed by sealed type-D canals, with 87.5%, and by blind type-B canals, with 75%. The loop type-C accessory canals were observed in only 5% of the teeth, and were the least prevalent

Chronic tibial defection in children treated with grafting of fibula with vessel pedicles and Lebone under external fixators / 中华创伤骨科杂志

Objective To report one stage treatment of chronic tibial defection in children. Methods 19 children with chronic tibial defection were treated in our department when their infection was at the stage of latency. First their focuses of infection were cleared away. Next a piece of fibula with vessel pedicles whose length was equal to that of the tibial defect was taken as the support to restore the length of the tibia. Then the external fixators were applied and a mixture of antibiotic and Lebone powder was used to fill the defect. Results In 15 cases the incision healed at one stage, slight infection occurred in 4 cases whose incisions healed after treatment of 3 to 4 weeks. Follow-ups of 0.5 to 1.5 years showed that no infection occurred again, bone defects healed well and limb function was satisfactory. Conclusion To treat chronic tibial defection in children at one stage, combined therapy should be applied. Grafting of fibula with vessel pedicles and Lebone under external fixators is a good one, because it can shorten the treatment time at no cost of satisfactory effects.

Comparison of high tibial osteotomy with giebel blade plate orstraddle nail internal fixation / 重庆医科大学学报

Objective:To compare the clinical effect of high tibial osteotomy (HTO) with Giebel blade plate or straddle nail internal fixation for the treatment of osteoarthritis of knee with varum.Methods:Twenty-three cases of knee OA with genu varum were performed with HTO,in which 8 case by using Giebel blade plate and 15 cases by using straddle nail.Results:All patients were followed up.The genu varum defection were corrected obviously.Six months after operation,comparison between the two groups showed no significant differences in scoring on HSS standard.One case of nail rupture and two cases of loss of anticipant angle occurred in the group of straddle nail.Conclusion:HTO with either Giebel blade plate or straddle nail both apparently shows many advantages in the treatment of osteoarthritis of knee.HTO with Giebel blade plate can exercise more early and have much less complications than HTO with straddle nail internal fixation.

Alar reconstruction by different methods of composite ear transplantation: a clinical evaluation / 中华医学美学美容杂志

Objective To select a simple and suitable operation metho d of composite ear transplantation according to the feature of alar defection an d personal characteristics, which can lead to a perfect reconstructional result with plump ala and symmetric nostril. Methods Evaluation standa rds, practical situation, attentions in operation, advantages and disadvantages of 3 methods of composite ear transplantation were determined from the follow-u p results in 26 out of 32 alar reconstruction cases in recent 5 years. R esults No obvious difference was found out of the results of the 3 meth ods of composite ear transplantation. Conclusions All the 3 met hods of composite ear transplantation are effective. Composite ear graft is simp le, with no further scar formation on face. Refluent axil ear flap pedicled by s upraorbital artery is suitable to bigger defection but the transplantation is re stricted by vessel condition. Composite ear flap transplantation with vessels an astomoses can reach a satisfactory result but the operation is complex. It is im portant to get a satisfactory reconstructive result that a suitable method is se lected according to the features of alar defection and personal characteristics.